Cardiomyopathy Clinical Trial
Official title:
The Effects of Ranolazine on CPET Parameters in Ischemic Cardiomyopathy Patients (ERIC)
This is a proof of concept trial using ranolazine, a medication, in patients with known Coronary Artery Disease and reduced left ventricular function, EF < 40%. We propose that ranolazine therapy will result in demonstrative improvements in cardiac function that can be objectively assessed using the parameters measured with CPET. We propose that demonstrative improvement in CPET parameters on ranolazine will translate into improved patient outcomes for this patient population.
Selected patients will undergo a CPET evaluation. The initial CPET will identify patients
with underlying ischemia and serve as a baseline study. Ischemia will be assessed using: 1)
peak VO2: measures the peak transport of O2 to the tissues when O2 extraction from the blood
is maximal; 2) the anaerobic threshold (AT): measures the sustainable work capacity in units
of VO2; 3) the O2-pulse measurements at the AT peak VO2: estimate stroke volume at those
levels of exercise; and 4) the relationship of O2 uptake to work rate (ΔVO2/ΔWR): provides
information on the ability of the cardiac output to increase. Patients whoseCPET results meet
the criteria for ischemia will be started on Ranexa 500mg BID and advanced within one week
+/-4 days to 1000mg BID. A second CPET will be performed after 4 weeks +/- 4 days of maximum
therapy. CPET results before and after therapy will undergo a statistical comparison. The
initial off treatment CPET measurement will serve as the control to assess changes found
during therapy. No medication changes or revascularization procedures will occur during the
study. If patients require and undergo a medication change or a revascularization procedure,
they will be excluded from the study.
Patients will be contacted at the completion of week one prior to up titration, then at the
end of week two to ensure tolerance and compliance with the 1000mg BID dose. Patients will
perform the second CPET study at week four +/- 1 week. The trial medication will be assessed
and counted to ensure that patients have taken there allotted pill count for the duration of
the study. Patients who are found to be noncompliant of less than 80% will be excluded from
the study.
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